Karen de Bijl-Marcus, Annemieke Johanna Brouwer, Linda S De Vries, Floris Groenendaal, Gerda van Wezel-Meijler
OBJECTIVE: To investigate the effect of a nursing intervention bundle, applied during the first 72 hours of life, on the incidence of germinal matrix-intraventricular haemorrhage (GMH-IVH) in very preterm infants. DESIGN: Multicentre cohort study. SETTING: Two Dutch tertiary neonatal intensive care units. PATIENTS: The intervention group consisted of 281 neonates, whereas 280 infants served as historical controls (gestational age for both groups <30 weeks)...
November 15, 2019: Archives of Disease in Childhood. Fetal and Neonatal Edition
Mark Krel, James Brazdzionis, Stacey Podkovik, Dan E Miulli, Margaret Rose Wacker, Yancey Beamer
Objective Stroke is the fifth leading cause of death in the United States and the leading cause of disability. Hemorrhagic stroke has higher risks of mortality and neurologic deficit. Higher still, acute intraventricular hemorrhage (IVH) has mortality between 50% and 80% while complicating subarachnoid hemorrhage in 15% of cases and intracerebral hemorrhage in 40% of cases. We sought to demonstrate that early adjuvant intraventricular recombinant tissue plasminogen activating factor (rt-PA) improved outcomes...
September 27, 2019: Curēus
Sudip Sheth, Lisa Goto, Vineet Bhandari, Boban Abraham, Anja Mowes
OBJECTIVE: To investigate factors associated with development of early and late pulmonary hypertension (E/LPH) in preterm infants with bronchopulmonary dysplasia (BPD). STUDY DESIGN: A retrospective case-control observational study of preterm infants with BPD admitted to a level IV referral neonatal intensive care unit over 5 years. We compared pre- and postnatal characteristics between infants with or without BPD-associated EPH and LPH. RESULTS: Fifty-nine out of 220 infants (26...
November 13, 2019: Journal of Perinatology: Official Journal of the California Perinatal Association
T Brett Kothe, Farouk H Sadiq, Nikki Burleyson, Howard L Williams, Connie Anderson, Noah H Hillman
OBJECTIVE: In preterm infants on moderately high ventilator support, the addition of budesonide to surfactant lowered bronchopulmonary dysplasia (BPD) rates by 20% without increased morbidity or mortality. The aim of this cohort comparison was to determine the safety and efficacy of the combination in infants with milder respiratory distress syndrome (RDS). INTERVENTION: In August 2016 we began administering budesonide (0.25 mg/kg) mixed with surfactant (Survanta 4 mL/kg) to all infants ≤ 1250 g who failed CPAP and required intubation...
November 12, 2019: Pediatric Research
Li Mei, Mu Fengqun, Han Qian, Su Dongpo, Guo Zhenzhong, Chen Tong
OBJECTIVE: To explore whether endoscopy surgery (ES) and external ventricular drainage (EVD) combined with intraventricular fibrinolytic (IVF) are superior to EVD-alone in patients with intraventricular hemorrhage (IVH), and to determine which procedure is more suitable in such patients. METHODS: We searched the following databases: PubMed, Medline, OVID, Embase, and Cochrane Library. Randomized controlled trials and non-randomized studies comparing at least two different interventions in patients with IVH...
November 4, 2019: World Neurosurgery
Ijab Khanafer-Larocque, Amuchou Soraisham, Amelie Stritzke, Essa Al Awad, Sumesh Thomas, Prashanth Murthy, Majeeda Kamaluddeen, James N Scott, Khorshid Mohammad
Objectives: To assess maternal and neonatal risk factors for intraventricular hemorrhage (IVH). To examine the association of patent ductus arteriosus (PDA) and its treatment, with IVH and its severity. Study design: In this retrospective cohort study, we included preterm neonates born at <29 weeks, admitted to a tertiary level III Neonatal Intensive Care Unit in Calgary, Canada, between 2013 and 2016, who had a head ultrasound in the first 7 days of life. A subset analysis included neonates who also had cardiac ultrasound in the first 3 days of life...
2019: Frontiers in Pediatrics
Susanna Leikos, Anton Tokariev, Ninah Koolen, Päivi Nevalainen, Sampsa Vanhatalo
The conventional assessment of preterm somatosensory functions using averaged cortical responses to electrical stimulation ignores the characteristic components of preterm somatosensory evoked responses (SERs). Our study aimed to systematically evaluate the occurrence and development of SERs after tactile stimulus in preterm infants. We analysed SERs performed during 45 electroencephalograms (EEGs) from 29 infants at the mean post-menstrual age of 30.7 weeks. Altogether 2,087 SERs were identified visually at single trial level from unfiltered signals capturing also their slowest components...
November 2, 2019: European Journal of Neuroscience
Georgios Alexopoulos, Michael Prim, Maheen Khan, Nabiha Quadri, Jorge F Urquiaga, Najib El Tecle, Jeroen Coppens
OBJECTIVE: The authors present the application of Brainpath endoport-assisted microsurgical device (EAMD) as a treatment modality for patients with severe intraventricular hemorrhage (IVH) secondary to spontaneous supratentorial intracerebral hemorrhage (sICH). METHODS: Patients with severe secondary IVH (defined as Graeb score > 6) who presented to Saint Louis University Hospital, USA, from 2017 to 2019 were treated with the minimally invasive approach for IVH evacuation using the atraumatic BrainPath aspiration system (NICO Corp, Indianapolis, Indiana)...
October 30, 2019: World Neurosurgery
Olga Romantsik, Matteo Bruschettini, David Ley
Germinal matrix-intraventricular hemorrhage (IVH) occurs in nearly half of infants born at less than 26 weeks' gestation. Up to 50% of survivors with IVH develop cerebral palsy, cognitive deficits, behavioral disorders, posthemorrhagic ventricular dilatation, or a combination of these sequelae. After the initial bleeding and the primary brain injury, inflammation and secondary brain injury might lead to periventricular leukomalacia or diffuse white matter injury. Potential factors that are involved include microglia and astrocyte activation, degradation of blood components with release of "toxic" products, infiltration of the brain by systemic immune cells, death of neuronal and glial cells, and arrest of preoligodendrocyte maturation...
November 2019: NeoReviews
Jia-Wen Li, Yu-Yu Xu, Ye-Jun Chen, Wei-Wei Fan, Xu-Hua Xu, Jin-Song Cai, Lu-Sha Tong, Feng Gao
AIMS: To explore the relationship between the circulating neutrophil-to-lymphocyte ratio (NLR) and the remote diffusion-weighted imaging lesions (R-DWILs) after spontaneous intracerebral hemorrhage (ICH). METHODS: Consecutive patients with spontaneous ICH were prospectively collected from November 2016 to May 2018 and retrospectively analyzed. We included subjects who presented within 24 hours after symptom onset and were free of detectable infections on admission or in hospital...
October 25, 2019: CNS Neuroscience & Therapeutics
Tijen Karsli, Viral G Jain, Maroun Mhanna, Qiang Wu, Samuel H Pepkowitz, Donald W Chandler, Prem S Shekhawat
BACKGROUND: Most neonatal outcomes in neonates are related to normal adrenal gland function. Assessment of adrenal function in a sick preterm neonate remains a challenge, thus we hypothesized that adrenal steroid precursors to their product ratios have a direct relationship with neonatal outcomes. STUDY DESIGN: We studied demographics of pregnancy and neonatal outcomes in 99 mother-infant pairs (24-41 weeks) and assayed 7 glucocorticoid precursors in the cortisol biosynthesis/degradation pathway...
October 23, 2019: Pediatric Research
Christos Chatzakis, Stefania Papatheodorou, Kosmas Sarafidis, Konstantinos Dinas, George Makrydimas, Alexandros Sotiriadis
OBJECTIVES: Prophylactic antibiotics are routinely recommended in preterm prelabour rupture of membranes (PPROM), but there is an abundance of potential treatments and a paucity of comparative information. The aim of this network meta-analysis was (i) to compare the efficiency of different antibiotic regimens on perinatal outcomes, and ii) to assess the quality of the current evidence. METHODS: We performed a network meta-analysis of randomized trials comparing prophylactic antibiotics, or regimens of antibiotics, to each other or to placebo, in women with PPROM...
October 21, 2019: Ultrasound in Obstetrics & Gynecology
Alexander Howes, Cathie Hilditch, Amy Keir
AIM: To answer the clinical question 'In infants about to be delivered and admitted to neonatal units, what clinical practice strategies, compared to standard care, have been shown to decrease incidence rates of intraventricular haemorrhage (IVH)?' METHODS: MEDLINE via Ovid (1943 to 5 January 2018), Embase via Ovid (1974 to 5 January 2018) and the Cochrane Library (5 January 2018) were searched for relevant articles. RESULTS: A total of 478 articles, after the removal of duplicates, were found and screened by title and abstract...
October 2019: Journal of Paediatrics and Child Health
Yu Chen, Li Ma, Junlin Lu, Xiaolin Chen, Xun Ye, Dong Zhang, Yan Zhang, Rong Wang, Yuanli Zhao
OBJECTIVE: Postoperative hemorrhage during the acute phase is rarely observed after revascularization surgery for moyamoya disease (MMD) but can have severe complications. Its risk factors and outcomes are still unclear. The aim of this study was to investigate the predictors of postoperative hemorrhage during the acute phase in MMD and examine the outcomes of the hemorrhage. METHODS: The authors reviewed the preoperative clinical characteristics and radiographic features of 465 consecutive MMD cases (518 procedures) that had undergone direct or combined bypass surgery at their institution between 2009 and 2015...
October 18, 2019: Journal of Neurosurgery
Kai Gong, Lizheng Zhao, Jianfeng Guo, Zhanxiang Wang
To establish a nomogram model to predict early cognitive impairment after supratentorial spontaneous intracranial hematoma in adult patients.A retrospective cohort study was held between January 2016 and October 2018. One hundred twenty seven out of 170 consecutive patients with supratentorial spontaneous intracranial hematoma were enrolled in this study. They were divided into development (n = 92) and validation (n = 35) dataset according to their admission time. Mini-mental State Examination (MMSE) was conducted between the third and the sixth month after the onset of stroke...
October 2019: Medicine (Baltimore)
Bogdan Iliev, Anna Schlegel, Dorothee Mielke, Veit Rohde, Vesna Malinova
Intracerebral hematomas (ICH) with intraventricular hemorrhage (IVH) are associated with high morbidity. Catheter-based thrombolysis with recombinant tissue plasminogen activator (rtPA) allows a faster hematoma resolution compared to conservative treatment. However, simultaneous thrombolysis of ICH and IVH is not achievable because the ependyma hinders ICH-lysis if rtPA is given into the ventricles and inversely. We evaluated if the thrombolysis efficacy is enhanced by placing an intrahematomal catheter reaching the ventricle...
October 14, 2019: Neurosurgical Review
Masaki Mino, Miki Fujimura, Hidenori Endo, Toshiki Endo, Kenichi Sato, Teiji Tominaga
Background : Management of hemorrhagic moyamoya disease (MMD) is one of the most challenging issues in neurosurgical practice. Recently, surgical revascularization by superficial temporal artery-middle cerebral artery anastomosis was reported to significantly reduce the risk of re-bleeding in hemorrhagic-onset MMD patients in the chronic state, but the optimal treatment strategy in the acute phase of hemorrhagic MMD is undetermined. Thus, we retrospectively analyzed our surgical results for hemorrhagic MMD in the acute stage, focusing on the efficacy of neuro-endoscopic management for hematoma removal...
October 12, 2019: Neurological Research
Cristina Sánchez Carabias, Pedro A Gomez, Irene Panero, Carla Eiriz, Ana María Castaño-León, Javier Egea, Alfonso Lagares, Igor Paredes, Jose Antonio Fernández Alén, Luis Miguel Moreno-Gómez, Daniel García-Pérez, Mario Chico-Fernández, Jesús Barea-Mendoza
OBJECTIVE: The volume and location of intracranial hematomas are well-known prognostic factors for traumatic brain injury (TBI). The aim of this study was to determine the relationship of serum biomarkers S100β, glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), total tau (T-tau), phosphorylated neurofilament heavy chain (pNF-H), serum amyloid A 1 (SAA 1), C-reactive protein (CRP), procalcitonin (PCT), and chitinase-3-like protein 1 (YKL-40) with TBI severity and the amount and location of hemorrhagic traumatic lesions...
October 10, 2019: World Neurosurgery
Jessica F J Rovers, Ingrid J C Thomissen, Lobke C E Janssen, Sjane Lingius, Bernice V Wieland, Jeanne P Dieleman, Hendrik J Niemarkt, Pieter J van Runnard Heimel
Introduction: Preterm birth is associated with increased mortality and morbidity. Tocolytic drugs, such as indomethacin, are often used to postpone preterm delivery. Indomethacin has been proven to be more effective than other tocolytic agents in terms of delaying birth but is often prescribed with caution because of its potential association with adverse neonatal outcomes. We aim to study the effects of antenatal indomethacin on neonatal outcomes after controlling for potential confounders, as compared to nifedipine and/or atosiban...
October 9, 2019: Journal of Maternal-fetal & Neonatal Medicine
Zachary A Vesoulis, Abigail A Flower, Santina Zanelli, Ami Rambhia, Maryam Abubakar, Halana V Whitehead, Karen D Fairchild, Amit M Mathur
BACKGROUND: The optimal upper and lower limits of blood pressure in preterm infants are not known. Exceeding these thresholds may contribute to intraventricular hemorrhage (IVH). METHODS: Preterm infants born ≤30 weeks GA were identified. Infants had continuous measurement of mean arterial blood pressure (MABP) for 7 days and cranial ultrasound imaging. IVH was classified as severe IVH (grade 3/4), no severe IVH (no IVH; grade 1/2), or no IVH. Mean ± SEM MABP values from hours 1-168 were calculated and sorted into bins 2 mm Hg wide...
October 2, 2019: Pediatric Research
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